Wednesday, June 3, 2009

Who needs cable when you have Emma


Emma was dressing for the day when Abby and I walked into her room. She instantly threw her hands over her "important parts" and proclaimed with about as much drama and pizazz that she could muster: "Don't look at me! I'm hideous!"
And then today as the girls were eating a snack of pork-n-beans (what can I say? We love those things.), Emma ate about half of her bowl-o-beans and paused to sneeze. She then immediately pushed her bowl away with a scowl and said, "Get those away from me. I allergic to beans!" When I foolishly tried to explain to the hard-headed 3 year old that she was not at all allergic to beans, she held her hand up to stop me and with confidence she argued, "Did you just hear me sneeze? Dat means I allergic!" Lord, help me when she becomes a teenager.With thankfulness, I am very happy to announce that Hailey is home from the hospital and doing very well. She's a strong little redhead! It is amazing that she had open-heart surgery just a week ago and is now doing well at home. Praise God for such wonderful news!

Nathan had a follow-up appt with his Pulmonologist today, and it went very well. The Pulmo is pleased with how well he is doing on the asthma meds. He also had Nathan's sleep study results today...For those medical enthusiasts, here are the key points to the study:

Sleep Efficiency: 81.5%
Total Arousals: 145 (16.2/hr)
Obstructive Apneas: 0
Mixed Apneas: 0
Central Apneas: 13

Hypopnea (overly shallow breathing): 11
AHI: 3.3

Moderate snoring (they believe this is hypotonic snoring since his tone is lowest in his trunk area)


Baseline O2 sats: 96%-98%

CO2>45 torr for 5% of total sleep time
Central apneas resulted in desats as low as 92%.
Hypopneas resulted in arousals and desats as low as 91%.


Final impression: Mild OSA with sleep disruption, desaturation, and rare hypoxemia.


The good news...Nathan does not require any respiratory support at this time. His O2 sats were not low enough long enough to cause too many problems yet, and his CO2 levels were not too high for too long.

The other news...While his sleep study wasn't too terribly bad, it was definitely not normal. While an AHI of 3.3 is considered normal in an adult, a child should not have an AHI that high. The Pulmo explained that an AHI of 2-5 in a child is considered mild sleep disorder, 5-10 is moderate, and anything over 10 is severe. This one study won Nathan the grand prize of a date with our sleep clinic every year from now on. Nice. (Can't you sense my eyes rolling out of my head onto our cluttered playroom floor?) The sleep report in layman's terms...he sleeps like crap. Not like I didn't already know that from the past 15 months of experience with Nathan's sleep habits, but whatevah.We had originally thought that his snoring was due to large tonsils/adenoids that were causing obstructive sleep apnea, but it is more than likely hypotonic snoring since he did not have any obstructive apneas. Instead, he was having central apneas which are neurological in origin...essentially, these are due to his brain failing to remind his body to breathe at times. Central apnea is always a symptom of an underlying problem and is often seen in neuromuscular diseases...in Nathan's case, it is due to his mitochondrial disease. The good thing is that his oxygen sats are not dropping too terribly low (low 90's) during these apneic events yet, and we will keep a close eye on his sleeping patterns over the next few years to see if there is any progression in his sleep issues.How's that for a load of medical jargon? Tomorrow's docket...a photography post!

4 comments:

Dana on June 3, 2009 at 10:08 PM said...

I love that photo of Emma w/the hat. Precious! She looks like you :-)

Jill on June 3, 2009 at 10:46 PM said...

Love the Emma-isms of the day! Feels funny to say it, but I'm glad to hear Nathan's horrible sleeping is just that, for now!

Krischa on June 3, 2009 at 10:46 PM said...

Your kids are just tooooo cute! Love the last one of the tush!!

~sydney~ on June 7, 2009 at 2:51 PM said...

emma, emma! cutie!

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